Predicting the Risk of Venous Thromboembolism Recurrence

Details

• Alternative Title:
  Am J Hematol
• Personal Author:
  Heit, John A.
• Description:
  Venous thromboembolism (VTE) is a chronic disease with a 30% ten-year recurrence rate. The highest incidence of recurrence is in the first 6 months. Active cancer significantly increases the hazard of early recurrence, and the proportions of time on standard heparin with an APTT ≥ 0.2 anti-X(a) U/mL, and on warfarin with an INR ≥ 2.0, significantly reduce the hazard. The acute treatment duration does not affect recurrence risk after treatment is stopped. Independent predictors of late recurrence include increasing patient age and body mass index, leg paresis, active cancer and other persistent VTE risk factors, idiopathic VTE, antiphospholipid antibody syndrome, antithrombin, protein C or protein S deficiency, hyperhomocysteinemia and a persistently increased plasma fibrin D-dimer. A recommendation for secondary prophylaxis should be individualized based on the risk for recurrent VTE (especially fatal pulmonary embolism) and bleeding. The appropriateness of secondary prophylaxis should be continuously reevaluated, and the prophylaxis stopped if the benefit no longer exceeds the risk.
• Subjects:
  Age Factors Anticoagulants Antiphospholipid Syndrome Body Mass Index Chronic Disease Fibrin Fibrinogen Degradation Products Heparin Humans Hyperhomocysteinemia International Normalized Ratio Neoplasms Paresis Protein C Deficiency Protein S Deficiency Recurrence Risk Factors Time Factors Venous Thromboembolism Warfarin

  More +
• Source:
  Am J Hematol. 2011; 87(Suppl 1):S63-S67.
• Pubmed ID:
  22367958
• Pubmed Central ID:
  PMC3383031
• Document Type:
  Journal Article
• Funding:
  DD000235/DD/NCBDD CDC HHS/United States ; HG04735/HG/NHGRI NIH HHS/United States ; HL66216/HL/NHLBI NIH HHS/United States ; HL83141/HL/NHLBI NIH HHS/United States ; R01 HL066216/HL/NHLBI NIH HHS/United States ; R01 HL083141/HL/NHLBI NIH HHS/United States ; U01 HG004735/HG/NHGRI NIH HHS/United States
• Volume:
  87
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:6353fda0fd0dc50b79ca50e60e56b16d2cf20a894d2f9d74ad3cc1fc4659b58a
• Download URL:
  https://stacks.cdc.gov/view/cdc/33393/cdc_33393_DS1.pdf
• File Type:
  [PDF - 522.72 KB ]